Herpes Zoster (Shingles)
Any person who has had chicken pox can have shingles. After a case of chicken pox, the virus that causes chicken pox remains in the body in a dormant stage (hibernation). Years later, it may become active and travel down the nerve. It results in a group of blisters in a pattern (mostly a line) that follows the nerve along that area of skin. Most often, shingles is on one side of the body. The skin lesions can occur any place on the body, although the most common place is on the trunk. About one out of five people will get shingles.
What causes the virus to come out of hibernation?
Most of the time there is no reason shingles appear. Most patients are in good health. This disease is a bit more common in persons over 50 years of age. Also, patients who have altered or low immunity have an increased risk for shingles. Thise would include persons on chemotherapy, long term steroids (such as prednisone), patients who have organ transplants or HIV/AIDS. If you have shingles, it is vital that you tell your doctor if you have any of these.
What problems can occur?
- Severe pain. This is the most frequent problem. It may last after the shingles heal. This is called post-herpetic neuralgia. Severe pain problems are more common in patients over the age of 50.
- Loss of muscle function. This is rare and mainly occurs when the shingles are in the head and neck area, mainly in the ear and ear canal.
- Eye problems. This is most common when the shingles are on the forehead and tip of the nose. Your doctor will most likely refer you to an eye doctor (ophthalmologist) if it affects your eye.
- Spread of the blisters. The blisters can spread over the body like chicken pox. This only happens in 3-4% of the cases.
- Scarring. This occurs if the shingles are severe or become infected with bacteria.
How is shingles diagnosed?
Most cases of shingles look alike and can be diagnosed by looking at the blisters. Sometimes, a scraping and exam with a microscope or a culture will be needed.
Is shingles contagious?
This disease is not highly contagious to people who have had chicken pox. If it is given to someone, they will get chicken pox, not shingles. The people most likely to catch it are those who have not had chicken pox, newborns, very ill patients, and those having chemotherapy. You should avoid direct contact with these people and with pregnant women.
How is singles treated?
Most patients who are healthy and under fifty years of age only need treatment to relieve symptoms. Medicine or pain relievers and cool water compresses help. The anti-viral drugs acyclovir, valacyclovir and famciclovir are used to treat shingles. They most often are given as pills, but acyclovir may also be given intravenously (IV) if needed. It works best when given very soon after the blisters appear. It shortens the course of the disease and often helps the pain. Your doctor will discuss this treatment with you.
UW Dermatology Department
1 S. Park St 7th Floor
Madison, WI 53715
Phone 608 287-2450
American Family Children’s Hospital
Pediatric Dermatology Specialty Clinic
1675 Highland Ave.
Madison, WI 53792
Phone 608 263-6420
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Last Updated: 02/13/2013
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